By: Kimberly Nelson, MA with Courtney Kelly
Receiving a diagnosis is a significant milestone on the road to recovery. It clarifies courses of treatment, supplies precedent, and gives rhyme and reason to symptoms that may otherwise be confusing or even scary. “Identifying a set of experiences with a name can often be a relief for those with mental health conditions. It helps them recognize that they’re not alone,” said Carrie Hanson, Clinical Director of CooperRiis Healing Community. When conceptualized appropriately, diagnoses are powerful tools patients and practitioners can use to identify targeted interventions, develop comprehensive treatment plans, and cultivate effective management strategies.
Mistake 1: Resisting Your Diagnosis
But conceptualized inappropriately, diagnoses can get in the way of recovery. Issues arise when mental health conditions are viewed as threats to established identities. Unable to integrate their psychological challenges with their sense of self, a person with this attitude towards their diagnosis may refuse to accept they’re struggling. Denial can easily devolve into delusion, and delusion makes it impossible for individuals to recognize how their mental health is impacting their lives. Healing can only begin when folks acknowledge it’s needed to begin with, so this stymies the recovery process at the start line.
As an example, mental health conditions have historically (and erroneously) been associated with “weakness.” This association has caused more than a few to resist treatment on the grounds that accepting a diagnosis would make them a weak person. But refusing to confront challenges doesn’t make them go away. It often makes them worse. If you believe you’re not “supposed” to be feeling anxiety when you are, you’ll not only start to feel anxiety about your anxiety, you’ll also be less likely to seek help for it.
Psychoeducation offers a powerful antidote to this type of denial. When people learn that mental health conditions have nothing to do with their character, that symptoms result from forces outside of their control—genes, traumas, environments, norms—they start to realize that diagnoses don’t undermine who they are. They can be strong, virtuous, courageous, and experience psychological challenges. In fact, accepting those challenges as real is itself a demonstration of strength, virtue, and courage.
Mistake 2: Becoming Your Diagnosis
On the flip side of resisting a diagnosis is letting it consume you. Also known as engulfment, overidentification with a mental health condition can be just as detrimental to the recovery process. This is especially true when paired with internalized stigma. A metastudy on the relationship between identity and recovery from severe mental illness found that the more negative associations a person had with their condition, the worse they’d fare during treatment. Patients with schizophrenia who believed they would never be able to live a purposeful, fulfilled life with their condition were more likely to isolate themselves from others, opt out of evidence-based programming, and fail to apply management strategies they learned.
Internalized stigma can be tricky to unpack, as it’s typically buried under years of acculturation. Our perspectives on mental illness are shaped by subtle (and not-so-subtle) messaging from the media, our family members, and the people in our communities, for better or worse. And in the case of the latter, “folks may view their health care providers as the ‘bearers of bad news’ rather than facilitators of healing,” explained Hanson. Given that a positive therapeutic relationship is critical to recovery, this mindset obstructs progress. To secure better treatment outcomes, patients must establish better outlooks on their lives.
Cognitive behavioral therapy can help. By equipping individuals with the tools they need to dismantle maladaptive beliefs, CBT can empower folks with mental health conditions to let go of the stigma that may be getting in the way of recovery. “Their careers, relationships, and even routines might look different than they once envisioned, but that doesn’t mean people with psychological challenges can’t live full, gratifying lives,” said Hanson. “Recovery is possible. For some people, it begins with learning to believe that.”
Mistake 3: Giving Up Control to Your Diagnosis
For others, it begins with recognizing that they still have agency in their lives. Overidentification can melt into entitlement for those who believe a diagnosis means they’re no longer responsible for their own actions. While it’s important to recognize that mental health conditions can impact or even impair decision-making, it’s also important to remember that all decisions have consequences. Having a diagnosis does not erase the harm a hurtful statement can cause, for example.
“Once, a resident had an angry outburst that frightened some of his peers. When we confronted him about his behavior, he said he couldn’t help it. We calmly pointed out that while his condition did make emotional regulation hard, he still had to apologize to those his actions affected,” recalled Hanson. By supporting him in doing so, this individual’s therapeutic team helped him exercise agency. And agency, like a muscle, strengthens with use.
It’s never a good idea for anyone to beat themselves up for something they said or did, mental health notwithstanding. The key is to balance self-compassion with accountability. Be cognizant of the internal and external factors impacting your decisions, but don’t relinquish accountability for them. Striking this balance will enable you to become an active participant in your life rather than a passive victim of circumstance.
Mistake 4: Focusing Exclusively on Your Diagnosis
Psychological conditions can make everything from retaining employment to getting out of bed extremely difficult. For this reason, it’s critical for folks with mental health conditions to nourish aspects of their identity that aren’t related to their diagnoses. Our behaviors emanate from our self-concepts; the person who defines themselves as “depressed” and nothing more is likely to act in line with that definition. But the person who defines themselves as a complex, multifaceted human being is empowered to act in line with their goals instead of their symptoms.
This is why connecting with core values is such an important practice for individuals suffering from mental health conditions. Doing so not only reinforces the fact that they are more than their diagnoses but also supports them in achieving self-actualization. “You can’t be your best self until you know who you are,” said Hanson, “and who you are is someone who has aspirations, someone to whom things matter.” A clear understanding of what you want out of life and why will motivate you to persist towards meaningful goals, even when symptoms make that hard.
When people conceptualize psychological challenges as opportunities for growth, the process of confronting those challenges becomes therapeutic. “Enrichment” occurs when a person accepts a diagnosis as a part of their story but does not let it drive their narrative. Equipped with their core values, supported by their providers, and in possession of their ambitions, their difficulties become arenas for self-discovery, and their hardships become hero’s journeys.